局灶性癫痫患者认知障碍的相关性分析  

Correlation analysis of cognitive impairment in patients with focal epilepsy

作　　者：杨希婷 毓青[1] 陈旨娟[2] 杨卫东[2] 陈英[1] 任梦若 韩晔楠 吕慧[1] 谭珂 YANG Xiting;YU Qing;CHEN Zhijuan;YANG Weidong;CHEN Ying;REN Mengruo;HAN Yenan;LV Hui;TAN Ke(Neurology Tianjin Medical University General Hospital,Tianjin 300052,China;Neurosurgery,Tianjin Medical University General Hospital,Tianjin 300052,China;Psychology,Tianjin University of Commerce,Tianjin 300134,China)

机构地区：[1]天津医科大学总医院神经内科,天津300052 [2]天津医科大学总医院神经外科,天津300052 [3]天津商业大学心理学,天津300134

出　　处：《癫痫杂志》2021年第2期98-103,共6页Journal of Epilepsy

摘　　要：目的通过神经心理评估探究局灶性癫痫患者可能产生认知障碍的相关因素。方法收集2016年3月—2020年1月于天津医科大学总医院门诊及住院的癫痫病患者53例,其中男25例,女28例,平均年龄(23.58±13.24)岁,平均病程(6.49±7.39)年,均符合2017年国际抗癫痫联盟(ILEA)局灶性癫痫的诊断标准,无进行性脑部疾病及脑部手术史。对入组患者进行相关的认知测评,应用SPSS统计软件对其各认知功能进行Spearman相关性分析,同时通过Logistic回归分析对认知的相关因素进一步分析,明确与认知相关的因素是否可能为局灶性癫痫患者认知损伤的危险因素。结果①Spearman相关分析显示局灶性癫痫患者总智商与教育水平、发病年龄、发作形式、发作总次数、抗癫痫药物(AEDs)和脑电图(EEG)间期放电侧别相关(P均<0.05);②二元Logistic回归分析显示,在所有认知相关的因素中,仅AEDs数量(P=0.003)和EEG间期放电(P=0.013)是造成局灶性癫痫患者认知障碍的危险因素。结论癫痫的临床治疗中要积极控制癫痫发作,但尽量减少药物的种类,当药物超过3种及3种以上时可以考虑手术治疗或其他非手术治疗。同时须定期复查EEG,以了解发作间期癫痫样放电的变化。Objective Through neuropsychological assessment,explore the factors that may cause cognitive impairment in patients with focal epilepsy.Methods Collected 53 epilepsy patients in outpatients and inpatients of Tianjin Medical University General Hospital from March 2016 to January 2020,including 25 males and 28 females,with an average age of(23.58±13.24)years old,and the course of disease(6.49±7.39),all met the 2017 ILEA diagnostic criteria for focal epilepsy,and there was no history of progressive brain disease or brain surgery.Carry out relevant cognitive assessments for the enrolled patients,use SPSS statistical software to conduct Spearman correlation analysis on the cognitive functions of the study subjects,and further analyze the related factors of cognition through Logistic regression analysis to clarify the factors related to cognition whether it may be a risk factor for cognitive impairment in patients with focal epilepsy.Results①Spearman correlation analysis showed that the FIQ of patients with focal epilepsy was related to education level,age of onset,seizure pattern,total number of seizures,AEDs and EEG interval discharge side(P<0.05).②Binary Logistic regression analysis shows that among all cognitive-related factors,only the number of AEDs(P=0.003)and EEG interval discharge(P=0.013)are the risk of cognitive impairment in patients with focal epilepsy factor.Conclusion In the clinical treatment of epilepsy,seizures should be actively controlled,but the types of drugs should be minimized.When there are more than 3 kinds of drugs,surgical treatment or other non-surgical treatments can be considered.At the same time,the EEG should be reviewed regularly to understand the changes in epileptiform discharges between episodes.

关 键 词：局灶性癫痫 认知功能 神经心理评估 相关性 危险因素 

分 类 号：R742.1[医药卫生—神经病学与精神病学]